Glue ear and hearing loss

What is glue ear?

Glue ear, or otitis media with effusion (OME) is persistent fluid in the middle ear space (middle ear effusion). This is the space behind the ear drum, which is usually filled with air, which gets there from the back of the nose through the eustachian tube.

It is common for kids (and occasionally adults) to have fluid in the middle ear space with viral infections and colds, and in a middle ear infection (acute otitis media) the middle ear space is filled with pus. If the eustachian tube is functioning, the fluid will usually clear by itself but if not, the fluid can persist and is then called glue ear or otitis media with effusion. Note that this can occur without having had a previous ear infection.

While the fluid is in the middle ear, the hearing is affected. The child isn’t completely deaf and can often hear quite well in quiet surroundings but will struggle when there is background noise such as in class or when the TV is going. Parents often describe “selective” hearing. In addition, the quality of the sound is altered (similar to blocking your ears with ear plugs or your fingers) which makes it difficult for the child to reproduce sounds and can interfere with speech development.

What else can cause hearing loss?

There are a wide range of potential causes which may be congenital (present at birth) or acquired. Many kids with congenital hearing loss will be detected in the newborn screening but this doesn’t rule out a hearing loss which develops later.

What should I look for?

Hearing loss can be subtle and can be easily missed. Signs to watch for include:

  • Speech or language delays.
  • Regularly saying "what".
  • Misunderstanding directions.
  • Wanting the TV louder than usual.
  • "Selective" hearing, difficulty hearing in background noise.
  • Declining school performance or behavioural problems in class.
  • Pulling at the ears.

What should I do about it?

If there is concern about the hearing, you should see your doctor to have the ears checked. If there is any doubt at all the child should be sent for a hearing test (which can be done even in very young children, and can be done without a referral through Attune or Neurosensory Unit), or referred to a specialist.